J.Jpn. Surg. Soc.. 65(7): 526-551, 1964

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Original article

EXPEFIMENTAL STUDIES ON THE PATHO-HISTOLOGICAL CHANGFS OF THE ENDOCRINE ORGANS AFTER CEREBRAL HEMISPHERECTOMY WITH SPECIAL REFERENCE TO THE PITUITARY GLAND

As the removal of the cerebral hemisphere is undergone technically at vear near position to the diencephalon, pituitary gland, it is of course considerable to give influence directly or indirectly to the diencephalon and the pituitary system. In fact, there are many foreign or domestic reports saying that the symptoms to be thought as a result of instability of the function in diencephalon-autonomic nerve system have been recognized after the operation.
To clarify these reacting mechrnism of the diencephalon, pituitary system accompanied to the removal of the cerebral hemisphere is important not only for elucidating pathologic physiology of the operation, but also clinically for the postoperative management. In the present studies, the influence of the operative strcss upon several endocrine organs, especially upon the pituitary gland, was patho-histologically investigated after cerebral hemispherectomy comparing with after other operations as controls.
The result were obtained as follows :
1) The degree of histological changes in the several endocrine organs was arranged according to the strength of operative stress in the following order, hemispherectomy with the stimulus-lesion of the diencephalon, hemispherectomy, frontal lobectomy, hepatectomy of the left lobe, and splenectomy. Further it was arranged by the endocrine organs in the following orders, the pituitary gland, testicles, adrenal gland.
2) The changes in the weight of the pituitary gland, thyroid gland, and testicles were not remarkable, but in case of the adrenal gland the degree of the changes were arranged by the operative stress in the same order in the paragraph-(1). The increase in the weight of the adrenal gland was recognized in the 2nd week after the operation when the most noted histological changes was found in the pituitary gland.
3) The histological changes in the adenohypophysis after the operations showed the decrease in numbers and atrophy of each thpe of cells, sepecially of δ cells, and besides that, remarkable increase of γ cells in number and its hypertrophy. These findings in the adenohypophysis weye evident in the 2nd week after hemispherectomy and this phenomena returned to the normal state after a month. After cerebral hemispherectomy with the stimulus-lesion of the diencephalon, the degeneration of each thpe of cells was extremely remarkable in the 1st week after the operation, and it was slight in those cases of frontal lobectomy, hepatectomy, and splenectomy.
The neurosecretory granules in the neurohypophysis remarkably decreased in the 2nd week after the operations, when the above mentioned histological changes were remarkable in the adenohypophysis
4) The pictures of defunctionalization of the thyroid gland were found in the 2nd week after hemispherectomy, and after frontal lobectomy, but in the 1st week after hemispherectomy with the stimulus-lesion of the diencephalon. The histological changes of the thyroid gland after hepatectomy and splenectomy were not svident.
5) The histological changes in the adrenal gland after both hemispherectomy and hemispherectomy with the stimuluslesion of the diencephalon showed the pictures of hyperfunction of the organ in around the 1st to 2nd week and it returned to normal a month after the operation. The changes in the adrenal gland were slight after frontal lobectomy and further it was more slight after hepatectomy and splenectomy.
6) Summarizing above mentioned changes in those endocrine glands, the changes after hemispherectomy were slightly higher than that after frontal lobectomy, but it showed essentially same patterns of the response to stress and there were not so much difference between both operations. On the other hand, from the presence of the remarkable changes in the endocrine organs after hemispherectomy with the stimuluslesion of the diencephalon, it is apparent that if the damage is involved in the diencephalon, the serious influence will be given the living body. From these it may be concluded that hemispherectomy itself performed without giving any damages to the diencephalon has no remarkable difference from the other kinds of operation in the brain from a view of responces of the endocrine organs to operation.

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